Provider Demographics
NPI:1295223881
Name:NEAL, ASHLEY COWAN (DC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:COWAN
Last Name:NEAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KINGFISHER
Mailing Address - State:OK
Mailing Address - Zip Code:73750-2739
Mailing Address - Country:US
Mailing Address - Phone:405-375-5483
Mailing Address - Fax:
Practice Address - Street 1:212 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750-2739
Practice Address - Country:US
Practice Address - Phone:405-375-5483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor